Al-Shifa Hospital in Gaza City, once the fulcrum of Gaza’s health system and now an emblem of its destruction, stood in ruins on Sunday, as if a tsunami had surged through it followed by a tornado.

The emergency department was a tidy, off-white building until Israeli troops returned there in March. Two weeks later, it was missing most of its facade, scorched with soot, and punctured with hundreds of bullets and shells.

The eastern floors of the surgery department were left open to the breeze, the walls blown off and the equipment buried under mounds of debris. The bridge connecting the two buildings was no longer there, and the plaza between them — formerly a circular driveway wrapping around a gazebo — had been churned by Israeli armored vehicles into a wasteland of uprooted trees, upturned cars and a half-crushed ambulance.

The hospital was the largest in Gaza, one of its biggest employers and a shelter for thousands of Gazans during war. I had visited its wards in calmer times, meeting Palestinians wounded in a previous conflict and doctors battling Covid-19. When I returned this week, the place was disfigured almost beyond recognition after a 12-day battle between Israeli soldiers and Gazan gunmen and an earlier raid by the Israeli military.

During a two-hour visit, I saw no Palestinians, but the Israeli soldiers who brought me there said there were still gunmen inside one building and a group of patients and doctors in another. Occasionally, we heard short bursts of gunfire. When the soldiers brought us to a vantage point overlooking the hospital, they told us not to linger long in the window in case a sniper saw us.

The symbolism of this hellscape differs according to the beholder, amid a deep divergence about how the conflict should be reported and explained.

To the Israelis who brought me to Al-Shifa on Sunday, the carnage is the result of Hamas’s decision to turn a civilian institution into a military stronghold, leaving Israel with no option but to enter it by force: Exhibit A in what they see as a war of necessity that they did not start.

“We had no alternative,” said Rear Adm. Daniel Hagari, Israel’s chief military spokesman, who led the visit. “We wanted to leave those places functional, but what happened was Hamas and Islamic Jihad were barricading and firing at our forces from the beginning.”

To the Palestinians who returned to Al-Shifa on Monday, searching for dead bodies after the Israelis withdrew, it was the embodiment of Israel’s perceived disregard for civilian life and infrastructure in its pursuit of Hamas: Exhibit A in what they see as a genocide of Gazans.

“As you see, this is Al-Shifa hospital after it was invaded and destroyed by the Israeli occupation forces,” said Motasem Dalloul, a Palestinian journalist, in a self-filmed video he sent from the wreckage on Monday.

“Or what was once Al-Shifa Hospital,” added Mr. Dalloul.

When we met before the war, Mr. Dalloul said that he is not a Hamas member but speaks regularly to its leaders and cadres; he has also acted as an interpreter for its officials.

Walking further through the compound, Mr. Dalloul encountered another man who blamed Israel for the destruction. “This occupation will die, Netanyahu will die, America will die — no matter how much they bomb us,” the unnamed man shouted. “No matter how much they bomb us and destroy Al-Shifa, the occupation will die,” he repeated.

Analysts have said that Israel’s return to Al-Shifa, more than four months after it was first captured, represents a strategic failure: It is the result of Israel’s unwillingness to set in motion any transition of power to forces independent of Hamas, creating a vacuum that has allowed Hamas to regroup.

The Israeli soldiers at Al-Shifa on Sunday portrayed the raid as a success. In one swoop, they said, they had killed about 200 fighters and captured 500 more — the majority, they said, of the remaining militants in northern Gaza. Gazan officials said hundreds of civilians were killed, a charge denied by Israel, and The New York Times could not independently verify either account.

In any case, the soldiers’ departure, hours later, means it will be possible for Hamas to return once again, unimpeded, raising the chances that Israel could return for a third raid in the future.

The Israeli military first captured the hospital site during a raid in November, exposing and destroying a subterranean tunnel network that Israel said was a Hamas command center.

After withdrawing from most of the city in January, the military returned to the hospital in March because it said remnants of Hamas’s military wing had regrouped in Israel’s absence, according to the officers who were escorting the international journalists, including two from The New York Times, to the site on Sunday.

To join the tour, we agreed not to photograph the faces of certain commandos and to stay with the Israeli forces at all times, but otherwise agreed to no other restrictions.`

Israel’s naval commando unit, Shayetet 13, swept into the hospital compound early on March 18. By Israel’s account, the destruction began after Hamas gunmen refused to surrender and started shooting at the Israeli forces, prompting them to return fire.

A spokesman for Hamas, Basem Naim, declined to comment on the claim that Hamas was operating inside the hospital but denied that its fighters were there; Hamas’s armed wing has said that it fired on Israeli forces in the vicinity of Al-Shifa, but stopped short of saying that it fought inside the compound.

The Israeli military said that one of the first men killed on March 18 was a security chief, Faiq Mabhouh, whose death was later mourned in a statement from Hamas. A map supplied by the Israeli military said there were at least 13 gunfights that broke out across different parts of the campus over the following two weeks, as the soldiers searched for holdouts hiding throughout the site.

The military said the damage to the emergency and surgery departments was so great because the gunmen had entrenched themselves inside those buildings, one of them inside an elevator shaft, forcing the Israeli commandos to fire repeatedly at their positions. The military said that it found several weapons caches hidden inside the hospital.

The military said the fighting was compounded by Gazan armed groups located outside the compound who also fired at Israeli soldiers, leading to gun battles around its perimeter and the killing of two Israeli soldiers outside the hospital. Hamas said on its social media platforms that its snipers and mortar teams had fired at Israeli forces in the vicinity of the hospital.

To support its claim of Hamas’s presence at the hospital, the Israeli military displayed digital copies of documents, branded with the logo of Hamas’s military wing, that it said were found at the site and which purported to document a meeting of the group’s militants inside the hospital. The Times could not verify the authenticity of the documents.

The Hamas-run authorities in Gaza have accused Israel of killing patients and displaced people sheltering at the hospital, as well detaining innocent people.

Yahia Al-Kayyali, a 58-year-old doctor, said he was detained by the Israeli Army during the raid while sheltering with his family at a building close to the hospital.

In a phone interview, Dr. Al-Kayyali said the soldiers forced him to strip, a common practice that Israel says is meant to ensure detainees do not conceal weapons, before beating him and his son, interrogating and blindfolding them, taking them to the roof and forcing them to sit on shattered glass for several hours.

They were later released after being made to walk south, he said.

“The soldiers treated us like animals,” he said.

The Israeli soldiers who escorted us on Sunday strongly denied any accusation of wrongdoing. They said they had evacuated more than half of the medics and patients to other health facilities, as well as allowing the vast majority of the 6,000 civilians who had sheltered at the hospital to move south. They said they had detained 900 people, 500 of whom they said were militants and about 400 others who were still being investigated. The numbers could not be independently verified.

“I’ve been here for 14 days,” said the Shayetet 13 commander, who asked to remain anonymous in line with military protocol. “It’s my soldiers. As far as I know, these accusations are a lie.”

According to both Israeli and Palestinian officials, more than 100 patients and medics were moved to a building on the western side of the compound, away from the worst of the fighting.

But there the narratives diverge. The Israeli military says that it did its best to provide food, water and medical care. The Gazan health ministry said in a statement that the remaining patients were left without enough medicine, clean water, food or sanitation, leaving some with septic wounds containing maggots.

“The situation as reported by many of the staff is horrific and inhumane,” the health ministry’s statement said.

Citing Palestinian medics, the World Health Organization said in a statement on Sunday that 21 patients had died since the raid began, and those remaining lacked diapers and bags for urine.

To Taysir al-Tanna, a surgeon who said he had worked for 25 years at Al-Shifa, the destruction of his hospital felt like a national tragedy.

He recounted by phone how the hospital — one of largest employers in both Gaza and the Israeli-occupied West Bank — had formed “a central place in our country.”

“Now, it’s become a wasteland,” Dr. al-Tanna said. “Try to imagine what that feels like.”

Aaron Boxerman contributed reporting from Jerusalem and Iyad Abuhweila from Istanbul.